Within this context, the Department strives for academic excellence in both its undergraduate and graduate programs. The primary mission of the undergraduate program is to provide a background of knowledge pertaining to normal and disordered communication, a foundation of ethical and clinical practice, and strong preparation for further graduate study in communication disorders. This mission is accomplished in the context of a broader liberal arts education. The primary mission of the graduate program is to provide professional preparation in the area of speech-language pathology.
This mission is accomplished in accordance with the standards set forth by the American Speech-Language-Hearing Association. The vision of the Department of Communication Disorders is to become a leading program in the region, providing exemplary and integrated academic, clinical, and research instruction to students, preparing them to become competent speech-language pathologists and leaders who can serve the members of a diverse and dynamic community.
You are here:. Department of Communication Disorders Continue to main content. The Department of Communication Disorders includes the study of language, speech and hearing, as well as communication disorders resulting from biological, environmental, and behavioral factors. Study in the Department of Communication Disorders prepares students for highly rewarding careers with the opportunity to work with a multitude of clients.
Center for Speech and Hearing. Learn More. Outcomes and Careers. Successful Outcomes Rate One hundred percent of students graduating from the Department of Communications Disorders report being employed or furthering their education within six months of graduation. Projected to Grow from to According to the Bureau of Labor Statistics , Employment of speech-language pathologists is projected to grow 29 percent from to , much faster than the average for all occupations.
Graduate Information. Department of Communication Disorders. Missouri Speech-Language-Hearing Association The Missouri Speech-Language-Hearing Association MSHA serves as the state association representing speech-language pathologists, audiologists, speech, language, and hearing scientists and related personnel associated with organized speech, language, and hearing education and health-care settings.
Other Professional Organizations The Missouri-Speech-Language-Hearing Association maintains a list of linked websites of other professional organizations pertaining to Communication Disorders.
A newer edition of Oxford Handbook of Geriatric Medicine is available. Latest edition 3 ed. Read More. Your current browser may not support copying via this button. All rights reserved. Communication also allows older adults to exert influence and to help others by listening, reflecting, and offering advice. If communication is compromised, social life is affected. People aging with cerebral palsy have lived their lives with a disability that may have increased with age, see the article by Strax and colleagues elsewhere in this issue for exploration of this topic.
Problems with communication may result in loneliness and difficulties in developing and maintaining social relationships. The investigators believe that loneliness and social isolation are not the same.
Loneliness is a subjective experience that correlates only weakly with objective characteristics, such as social network size or frequency of contact with friends. Analyses of these interviews suggested that these participants experienced loneliness for some of the same reasons as older adults without lifelong disability, including being without a partner or feeling of reduced person control.
Communication disorders appear to put an additional burden on people aging with cerebral palsy at least in part due to unsuccessful communication with unfamiliar conversational partners, insufficient time for satisfactory communication, and unacceptable telephone communication.
MS is a progressive neurologic condition that is typically diagnosed in mid-life when people are engaged in many preexisting roles, such as parent, spouse, friend, employee, or homemaker.
An important challenge is the premature transition out of valued roles that were expected to continue into older age. For example, they may need to retire long before their nondisabled peers. Analysis of a series of in-depth interviews of people with MS who were experiencing mild communication problems suggests that participation in important roles changed markedly, not only because of the communication problems but also because of issues related to fatigue, cognitive changes, and mobility limitations commonly associated with MS.
Others expressed frustration in relinquishing their valued roles. Thus, many of the life transitions made by peoplewith MS occur beforethe expected time. When these transitions are rapid or undesirable, psychosocial stress may occur. Dual sensory loss decreased vision and hearing acuity is increasingly common especially in the very old and those in institutional settings.
In a survey of people with dual sensory loss, more than two-thirds reported frequent difficulty in conversation especially in noisy situations or with groups.
Aphasia is a language impairment commonly associated with left hemisphere stroke. Davidson and colleagues 30 observed older people with aphasia in everyday communication situations. They found that people with aphasia engaged in similar activities as older people without disability.
For example, conversation was the most common activity for both groups. However, differences were evident in the frequency of communication activities and in specific activities such as making telephone calls, reading, writing, and business activities such as making appointments or completing forms.
Thus, communication activities that were rated as important by older community-dwelling adults were more limited in those with communication disorders. Older adults with aphasia also had fewer communication partners and took part in fewer social situations than peers without aphasia. These differences were viewed as documentation of losses in relationships and social networks experienced by people with aphasia. The differences may reflect a lack of connectedness reported by older adults with aphasia.
Although maintaining social roles is important to people as they age, another significant concern is the ability to access services that they perhaps have not needed in the past, or that they now need to a greater degree. Health care is a primary example of these types of services. The ability to communicate successfully, including speaking, listening, reading, and writing, is a critical factor in obtaining health care. Communication disabilities are especially common in the hospital setting.
These patients were more likely to be older men. The presence of a communication problem was significantly associated with an increased risk of experiencing a preventable adverse event. Limitations in communication also have an undesirable affect on outpatient health care, where time is increasingly limited for patient visits and health care relies more on communication via written information, telephone, and computer eg, e-mail.
Research focused on the Medicare population suggests a significant relationship between the presence of communication problems and dissatisfaction with health care including overall quality, accessibility, and receipt of information.
In their review of empiric studies examining the physician-older patient interaction, Adelman and colleagues 36 found that several dimensions were better with younger rather than older patients. These included physician responsiveness eg, the quality of questions , agreement in setting major goals, and joint decision making. Another issue that distinguished physician visits in the geriatric population is the frequent presence of a third party. As much as half of the time, the older patient is accompanied to the visit by someone else who may play the role of advocate, passive participant or antagonist.
The term ageism has been used to describe an important barrier to good communication between health care providers and older patients. It is also associated with interaction patterns in which the physician dominates. Although people aging with communication disabilities are certainly a heterogeneous group, some issues with important clinical implications are common to all.
First, research suggests that quality of life in older adults is related to more than health status. Social contacts may be as valued as health status in quality of life.
Second, the burden of disability is cumulative with the added conditions associated with aging. Because the burden of disability increases with aging, adaptive resources may be insufficient to accommodate the cumulative effects of these sources of disablement. Finally, the presence of communication problems is especially taxing in areas in which older adults are experiencing increasing needs, such as accessing health care.
Communication disabilities hinder the implementation of strategies to compensate for many aspects of disablement. Therefore, health care providers should be aware of potential communication disabilities and make provisions for these problems when interacting with older adults.
The final section provides a review of issues and suggestions for enhancing communication in health care settings and in everyday social interaction. Health literacy, defined as the ability to understand the basic health information and services necessary for making appropriate decisions about health services, is becoming an increasingly critical factor in health care communication.
It has been estimated that one-third of people older than 65 years have inadequate or marginal health literacy. Although accommodations such as wheelchair ramps to allow physical access to health care and other facilities are now taken for granted, similar accommodations to improve access to health care settings for those with health literacy issues are often not acknowledged as part of standard clinical practice.
Iezzoni and colleagues 35 suggest that 3 types of accommodations in health care settings are needed to improve access to health care for people with communication disorders.
These include brick and mortar eg, a quiet room with furniture that allows eye to eye contact , tools eg, reading material appropriate for people with aphasia , and policy changes eg, longer appointments. A list of general suggestions for communicating with older adults with communication disabilities is provided in Box 1.
Excellent resources are also available to guide patients in talking with doctors. Their recommendations for effective written material focus on content eg, inclusion of a clear purpose statement , language eg, aim for 5th to 6th reading grade level , organization eg, use subheadings and bulleted lists , layout eg, use large print , and illustrations eg, use simple line drawings.
Make sure that sensory aids eg, eye glasses, hearing aids, communication devices, memory aids are available and used. Make sure the environment is communication friendly, that is, quiet, well lit, furniture arranged for face-to-face interactions. Provide take-home educational material in the preferred format and at the appropriate reading level. In addition to these types of accommodations, it is important to identify the roster of decision makers who will be involved in the care of each individual patient.
This set of decision makers may be large, diverse, and changing, and may include those who accompany the older person to the health care visit and those who do not, for example, distant adult children.
The goals of this partnership include identification of the problems, potential option or options and expectations, and the pros and cons of each option. These studies suggest that the interview is integral to the process and outcomes of medical care. Interpersonal communication skills are considered so important that they are a core competency identified by the Accreditation Council on Graduate Medical Education and the American Board of Medical Specialties.
Learning — and using — effective communication techniques may help you build more satisfying relationships with older patients and become even more skilled at managing their care. Establish respect right away by using formal language. As one patient said, "Don't call me Edna, and I won't call you Sonny. Or, you might ask your patient about preferred forms of address and how she or he would like to address you. Avoid using familiar terms, like "dear" and "hon," which tend to sound patronizing.
Be sure to talk to your staff about the importance of being respectful to all your patients, especially those who are older and might be used to more formal terms of address. Ask staff to make sure patients have a comfortable seat in the waiting room and help with filling out forms if necessary. Be aware that older patients may need to be escorted to and from exam rooms, offices, restrooms, and the waiting area.
Staff should check on them often if they have a long wait in the exam room. Introduce yourself clearly and do not speak too quickly. Show from the start that you accept the patient and want to hear his or her concerns. In the exam room, greet everyone and apologize for any delays. With new patients, try a few comments to promote rapport: "Are you from this area? Older people may have trouble following rapid-fire questioning or torrents of information.
By speaking more slowly, you will give them time to process what is being asked or said. If you tend to speak quickly, especially if your accent is different from what your patients are used to hearing, try to slow down.
This gives them time to take in and better understand what you are saying. Avoid hurrying older patients. Time spent discussing concerns will allow you to gather important information and may lead to improved cooperation and treatment adherence. Feeling rushed leads people to believe they are not being heard or understood.
Be aware of the patient's own tendency to minimize complaints or to worry that he or she is taking too much of your time. If time is an issue, you might suggest that your patients prepare a list of their health concerns in advance of their appointments. The National Institute on Aging has information on doctor-patient communication for older adults. One study found that doctors, on average, interrupt patients within the first 18 seconds of the initial interview.
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